Intersex

[Tootsurly]

Bit of a thought experiment, plus curious as to how much people know about intersex conditions / DSDs.

This is slightly Black Mirror, although not totally beyond the realms of possibility. If there ever came a point where anything specifically related to being male or female required a DNA test to determine your sex before participating, what would happen to intersex people whose chromosomes didn't match their outward appearance (i.e. genotype and phenotype don't match)?

Not chromosomes, but specific genes within chromosomes.

Your scenario rests on the premise that humans have a total understanding of the human genome. Which we do not.

The discovery of the SRY gene was a massive step in our understanding. But it's not the whole picture. Since then, various other genes have been found to play a part in sex determination.

Even with the incomplete picture we have now, a simple cheek swab would give you a person's sex.

On top of that you have the sociological argument of how we categorise those with certain conditions. This is most clearly shown in the discussion around those with CAIS, who are biologically male, but are generally accepted as female, given the fact thay cannot process androgens.

There are some incredibly rare conditions that do not fit into XX / XY. As they are discovered they are surprising drs because it really isn't that simple, and because they are so rare they often only come to light when professional sport is involved (you wouldn't know in everyday life)

I think where situations are segregated by biological sex, those who have dsd need to be considered on an individual basis, that said it is rare so on most situations it is pure theoretical.

Put simply, a Y chromosome probably gives you greater strength etc?

Foetuses are not female by default. Sex is determined at conception.

Well yes it is 100% due to their chromosomes or more specifically their genes on all 23 pairs (plus or minus any additional/missing). It’s not just whether they are XX XY or any other combination of that chromosome pair - eg 5ARD is XY with presumably a gene elsewhere that means the relevant parts of their body are resistant to androgens so develop along a more externally visible female path. Still a man with a male DSD.

in your hypothetical cheek swab situation - most people will look exactly how you would expect given their XX/XY swab. Anyone who doesn’t visibly/medically match (eg XY CAIS) will have further investigation to identify the exact DSD. There is then a decision to be made by someone (not sure who) as to whether these would be classified as male or female. Medically an XY CAIS still has to be screened for prostate not ovarian cancer, but in day to day life would be female.

focussing on these edge cases is not a good reason to say that a cheek swab is pointless for 99.9+% of people/situations.

Well it is, I guess - but only in the case of a very small proportion of the population. (0.018% or 1.7% (and probably figures in between), depending on who you ask and how it's defined.)

"Yes, you can be a male or a female with a DSD - I agree with that. And intersex is a misnomer in that sense".

You ARE a male or female, even if you have a DSD. DSDs are specific to sex. There is nothing in between. No third sex.

It's only 1.7% if you include women with pcos

Sex is determined at conception. There is no default sex.

People erroneously believe this because early foetal gonad development resembles a female phenotype.

So you would class someone with a uterus, fallopian tubes, a cervix, a vagina and vulva (and no penis or prostate) as a man?

I never said a cheek swab was pointless, I asked what one would do in the case of people with a DSD.

What do you mean what would happen to them? Hopefully they'd be left to live their life in peace?

Not in and of itself, no.

No, it includes those with PAIS, of which all are women. If you added PCOS on top, the number would be much higher.

The figures are around 0.2% if you remove women with PAIS, and 0.0018% are conditions that result in ambiguous genitalia.

You have not described a person with CAIS here.

Those with CAIS have no uterus, cervix or fallopian tubes.

Yes, sex is entirely determined by chromosomes.

For the 99.9% of people who are XX or XY with no sex-chromosomal abnormalities this is straightforward.

For the remainder, the specific type of DSD determines whether they are male or female. There is one XY DSD - Swyer’s - that results in a phenotypical female, albeit without ovaries. Another - CAIS - results in a person who appears female but who has no uterus and has undeveloped testes.

I’d suggest that the national ID card in your fictional scenario of someone with Swyer’s or CAIS should indicate them to be female. Someone with 46 XY-ARD, however, is male, as they will undergo male puberty.

Is this one of those 'wide-eyed thought experimenters' where the naivety slowly becomes aha gotcha nasty wims?

Not that the gotcha ever actually is, but there's just something about the tone...

I'm talking about everyday situations, like hospital wards, toilets, single-sex social events.

Well you haven't specified so difficult to follow your hypotheticals tbh.

I would imagine in your examples the current status quo would apply - so external genitalia giving the appearance of female, no male-type onset of puberty and thus the belief the person is female, they'd use women's loos.

Sports where testosterone levels and male puberty confer an advantage, then categorised as male regardless.

Is this supposed to be some sort of gotcha?

It’s a completely unambiguous term, to most people?

In the vast majority of people it really isn't complicated!

People with DSDs or VSDs have asked not to be used as a political football or shield.

I should think they feel the same way about being used as thought experiments for other groups. Good account of this within another thread:

TERFs are not the problem
www.mumsnet.com/talk/womens_rights/5221125-terfs-are-not-the-problem?reply=140269669&utm_campaign=thread&utm_medium=share

It used to be believed that all foetuses began to develop along the female pathway. This was found to be an incorrect assumption. What was actually happening was that in the early stages of development, you can't tell the sex by looking at the foetus (however, they do have a sex).

'Intersex' is very old fashioned and I have been told (by someone with Kinefelters who I quote) that "it is similar to 'spastic'" in terms of being extremely insulting (to this person who is male and definitely not inbetween).

https://www.theparadoxinstitute.com/read/sex-development-charts

CAIS is not the only DSD.

I have described someone with Swyer's Syndrome.

The person you responded to didn't mention Swyers, so why would you assume they thought someone with Swyers would be a man?

I have a dystopian fantasy of my own that raises this question 😂 It involves a club/hotel type establishment for women. Should the genderist agenda have succeeded, membership requires a cheek swab or blood test on application. I chewed over quite a few issues with this.

Unsurprisingly to anyone but myself, I settled on the very same approach I currently take in life. XY people with Swyer Syndrome can join, if they're keen enough to undergo my club's testing. No other XY people may, no matter how androgen insensitive they are or how they think they identify.

XX people with de la Chapelle syndrome may not join because they're 'effectively' men (as the Swyer's people 'are' women). So-called trans men may not because, although they're women, they're trying to abandon their female sex so don't belong in my club.

I never use the term intersex; there are no sexes between or beyond female and male. And I wish my club was real!

The 1.7% claim ('as common as redheads') made by Fausto - Sterling has been utterly discredited.

Verity, the PCOS charity, had to make a public statement to clarify that PCOS is not an 'intersex' condition.